BEVERLY DAWN MOOSE (NPI# 1487747648) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1487747648 |
| Entity Type | Individual |
| Full Name | BEVERLY DAWN MOOSE |
| Credential | MD |
| Practice Address |
3333 Silas Creek Pkwy Winston Salem NC 27103-3013 |
| Mailing Address |
Po Box 30337 Winston Salem NC 27130-0337 |
| Practice Telephone | 3367185095 |
| Practice Fax Number | 3367189895 |
| Mailing Telephone | 3367188592 |
| Mailing Fax Number | 3367189269 |
| Enumeration Date | 2006-10-02 |
| Last Update Date | 2012-12-11 |
| Gender Code | F |
| Is Sole Proprietor | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 2085R0001X |
Radiology Specialization: Radiation Oncology |
96-00124 | NC | Allopathic & Osteopathic Physicians |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| VA | 5860531 | 05 | |
| CIGNA HEALTH CARE | 6760232005 | 01 | |
| UNITED HEALTH CARE | 2408394 | 01 | |
| MEDCOST | 97953 | 01 | |
| PARTNERS NATIONAL HEALTH | 13799 | 01 | |
| NC | 8960531 | 05 | |
| NC | BLUE CROSS/BLUE SHIELD | 60531 | 01 |
| Street Address |
3333 SILAS CREEK PKWY |
| City | WINSTON SALEM |
| State | NC |
| Zip Code | 27103-3013 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700880440 | Joy L Csikos | Physician Assistant | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2005-06-10 |
| 1861092421 | Madison Ann Cline | Physician Assistant | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2020-10-31 |
| 1285241083 | Erin Elphick | Physician Assistant | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2020-09-25 |
| 1851909626 | Alex Joseph Holton | Registered Nurse | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2020-07-17 |
| 1497370191 | Karen Shugart | Nurse Practitioner | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2020-06-09 |
| 1831721299 | Brianna Elaine Marks | Nurse Practitioner | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2020-02-04 |
| 1952946659 | Jennifer Michelle Lucio | Nurse Practitioner | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2019-11-18 |
| 1336799527 | Novant Medical Group, Inc. | Obstetrics & Gynecology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2019-09-19 |
| 1467001503 | Hannah Dibble Palmer | Nurse Practitioner | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2019-09-11 |
| 1659926012 | Jamie Kornelis Hobson | Registered Nurse | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2019-08-02 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1124648126 | Kelly Anne Wales | Pharmacist | 3917-a Westpoint Boulevard, Winston-salem, NC 27103 | 2020-04-20 |
| 1386281533 | Elena Mcginty | Nurse Practitioner | 1225 Creekshire Way, Suite 270, Winston Salem, NC 27103 | 2019-12-06 |
| 1992359442 | Madeline Pryor | Pharmacist | 255 Charlois Drive, Winston Salem, NC 27103 | 2019-08-01 |
| 1215599584 | Palmetto Oxygen LLC | Durable Medical Equipment & Medical Supplies | 1100 S Stratford Road, Building B, Suite 420, Winston Salem, NC 27103 | 2019-07-07 |
| 1548734718 | Trivy Johnson | Specialist | 1384-b Westgate Center Dr., Winston Salem, NC 27103 | 2019-01-21 |
| 1447745047 | Novant Health Rehabilitation Hospital of Winston-salem, LLC | Rehabilitation Hospital | 2475 Hillcrest Center Circle, Winston Salem, NC 27103 | 2018-06-26 |
| 1346740206 | Joseph Miller | Physical Therapist | 1605 Westbrook Dr, Suite 103, Winston-salem, NC 27103 | 2018-02-17 |
| 1548779101 | Kristin Blow | Counselor | 3000 Bethesda Pl Ste 202, Winston Salem, NC 27103 | 2017-09-27 |
| 1891213443 | Alisha Dawn Wilson | Occupational Therapy Assistant | 2101 Homestead Hills Drive, Winston Salem, NC 27103 | 2017-09-05 |
| 1588186969 | Brandy Wilson | Social Worker | 153 Cameron Way Circle, Winston Salem, NC 27103 | 2017-07-07 |
| Find all providers in zip 27103 | ||||
| Taxonomy Code | 2085R0001X |
| Grouping | Allopathic & Osteopathic Physicians |
| Classification | Radiology |
| Specialization | Radiation Oncology |
| A radiologist who deals with the therapeutic applications of radiant energy and its modifiers and the study and management of disease, especially malignant tumors. |
| Notes: Source: American Board of Medical Specialties, 2007. www.abms.org [7/1/2007: definition added, source added; 7/1/2011: modified source] - Additional Resources: American Osteopathic Board of Radiology, 2007. http://www.osteopathic.org/certification |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1205214848 | Ryan Thomas Hughes | Radiology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2015-05-15 |
| 1184069478 | Philmo Youngmin Oh | Radiology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2013-05-01 |
| 1184903205 | Christina Kehl Cramer | Radiology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2011-08-07 |
| 1508094681 | Jeffrey G Kuremsky | Radiology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2009-06-26 |
| 1225151152 | Michael David Chan | Radiology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2007-04-07 |
| 1326165663 | Doris Brown | Radiology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2007-03-23 |
| 1356426548 | James Anthony Palermo | Radiology | Medical Center Blvd, Winston Salem, NC 27157-0001 | 2006-10-26 |
| 1134219108 | Piedmont Radiation Oncology P A | Radiology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2006-10-13 |
| 1326131509 | Judith Di Rocco Sears | Radiology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103 | 2006-10-02 |
| 1952494122 | Lisa Smith Evans | Radiology | 3333 Silas Creek Pkwy, Winston Salem, NC 27103-3013 | 2006-10-02 |
| Find all providers in WINSTON SALEM | ||||
| City | WINSTON SALEM |
| Zip Code | 27103 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.